December 18, 2013

Some Truth Behind The Saying ‘Apple A Day Keeps The Doctor Way’

An apple a day might just keep the doctor away for people aged 50 and over, according to a study published in The British Medical Journal.

Researchers found eating apples helped prevent or delay around 8,500 vascular deaths such as heart attacks and strokes every year in the UK. This finding is similar to giving statins to everyone over 50 years who is not already taking them. Statins have been proven to reduce the risk of vascular events, irrespective of a person’s underlying risk of cardiovascular disease, which has led to calls being made for greater use of statins at a population level for people over 50.

The team, from the University of Oxford, set out to test the 150 year old proverb of “an apple a day keeps the doctor away.” They used a mathematical model to test how the proverb might compare with the more widespread use of statins in the UK population.

The researchers analyzed the effects on the most common causes of vascular mortality of prescribing either a statin a day to those not already taking one or an apple a day to everyone in the older age category. They assumed a 70-percent compliance rate with overall calorie intake remaining constant.

The team estimated 5.2 million people are currently eligible for statin treatment in the UK and 17.6 million people who are not currently taking statins would be offered them if they became recommended as a primary prevention measure for everyone over 50. They calculated that offering a daily statin to 17.6 million more adults would reduce the annual number of vascular deaths by 9,400, while offering a daily apple to 70 percent of the UK population over the age of 50 would avert 8,500 vascular deaths.

While statins proved to prevent more vascular deaths, the drug also showed its dark side through side-effects. The team said that prescribing statins to everyone over the age of 50 is predicted to lead to over a thousand extra cases of muscle disease and over ten thousand extra diagnoses of diabetes.

An additional model showed another three percent reduction in the annual number of vascular deaths when either apples or statins were prescribed to everybody over 30 years old. However, the number of adverse events is predicted to double.

"This study shows that small dietary changes as well as increased use of statins at a population level may significantly reduce vascular mortality in the UK," the authors wrote in the journal. "This research adds weight to calls for the increased use of drugs for primary prevention of cardiovascular disease, as well as for persevering with policies aimed at improving the nutritional quality of UK diets.”

Dr Adam Briggs, of the BHF Health Promotion Research Group at Oxford University said this century old proverb looks to be right after all.

"The Victorians had it about right when they came up with their brilliantly clear and simple public health advice: ‘An apple a day keeps the doctor away.’ It just shows how effective small changes in diet can be, and that both drugs and healthier living can make a real difference in preventing heart disease and stroke,” Briggs said in a statement. “While no-one currently prescribed statins should replace them for apples, we could all benefit from simply eating more fruit."